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Pediatrics. 2016 Feb;137(2):e20151728. doi: 10.1542/peds.2015-1728. Epub 2016 Jan 12.

Neurodevelopmental Outcomes After Neonatal Surgery for Major Noncardiac Anomalies.

Author information

1
Paediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands Brain Center Rudolf Magnus, University Medical Center, Utrecht l.j.stolwijk@umcutrecht.nl.
2
Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands.
3
Paediatric Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands.
4
Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Netherlands Brain Center Rudolf Magnus, University Medical Center, Utrecht.

Abstract

CONTEXT:

Increasing concerns have been raised about the incidence of neurodevelopmental delay in children with noncardiac congenital anomalies (NCCA) requiring neonatal surgery.

OBJECTIVE:

This study aimed to determine the incidence and potential risk factors for developmental delay after neonatal surgery for major NCCA.

DATA SOURCES:

A systematic search in PubMed, Embase and the Cochrane Library was performed through March 2015.

STUDY SELECTION:

Original research articles on standardized cognitive or motor skills tests.

DATA EXTRACTION:

Data on neurodevelopmental outcome, the Bayley Scales of Infant Development, and risk factors for delay were extracted.

RESULTS:

In total, 23 eligible studies were included, reporting on 895 children. Meta-analysis was performed with data of 511 children, assessed by the Bayley Scales of Infant Development at 12 and 24 months of age. Delay in cognitive development was reported in a median of 23% (3%-56%). Meta-analysis showed a cognitive score of 0.5 SD below the population average (Mental Development Index 92 ± 13, mean ± SD; P < .001). Motor development was delayed in 25% (0%-77%). Meta-analysis showed a motor score of 0.6 SD below average (Psychomotor Development Index 91 ± 14; P < .001). Several of these studies report risk factors for psychomotor delay, including low birth weight, a higher number of congenital anomalies, duration of hospital admission, and repeated surgery.

LIMITATIONS:

All data were retrieved from studies with small sample sizes and various congenital anomalies using different neurodevelopmental assessment tools.

CONCLUSIONS:

Cognitive and motor developmental delay was found in 23% of patients with NCCA. Meta-analysis showed that the mean neurodevelopmental outcome scores were 0.5 SD below the normative score of the healthy population.

PMID:
26759411
DOI:
10.1542/peds.2015-1728
[Indexed for MEDLINE]
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